By now many of you have heard of the new Medicare Quality Payment Program (QPP), born out of the Medicare and CHIP Reauthorization Act of 2015 (MACRA) that went into effect this year. The QPP completely revamps the way Medicare pays its providers and is made up of two tracks, the Merit-Based Incentive Payment System …
Category: Health Center Regulatory Issues
Uncertainty Remains in the Marketplace
On April 13, 2017 CMS issued its final rule designed to make the ACA Marketplaces more appealing to insurers. Under this final rule, starting for the 2018 plan year: The annual Open Enrollment Period will be shortened from 3 months to 6 weeks States will have full authority to determine if an insurer’s network has …
CMS, HHS Send Letter to Governors on Medicaid
Just after her Senate confirmation as Administrator of the Centers for Medicaid Services (CMS), Seema Verma joined HHS Secretary Tom Price in a letter to governors on their commitment to work together to improve the Medicaid program. The letter states that the federal framework for Medicaid has not “kept pace with emerging evidence around the …
The New Medicaid Landscape: How the Administration May Increase Flexibility for States
While it is unclear what changes Congress may make to the Medicaid program, even without further Congressional action, changes are coming to Medicaid. The recent Senate confirmations of Health and Human Services Representative Tom Price as Secretary of Health and Human Services and Seema Verma as Administrator of the Centers for Medicare and Medicaid Services …
CMS Issues Proposed Rule on “Market Stabilization” for the ACA Marketplaces
On February 15, 2017, CMS issued its proposed rule on “market stabilization” in the Affordable Care Act’s Marketplaces. This proposed rule is one of the first issued by the Trump Administration. Below you will find a summary of the major provisions of the proposed rule and can read NACHC’s comments on the proposed rule here. We …
2016: A Regulatory Year in Review
NACHC’s Regulatory Affairs Department has seen a lot of action over the last year, as the current Administration is wrapping up its remaining days in Washington, DC and has been working to propose and finalize a wide range of policy and administrative activities. Highlights have included: CMS: The final rule governing Medicaid Managed Care Plans: …
Are you an Essential Community Provider?
Are you on the list? CMS has released its draft 2018 Essential Community Provider list, the list used by Qualified Health Plans in the Marketplace to meet the ECP contracting requirement. Take a look at the announcement below to find out how to determine if you are on the list and if not, how …
CMS Issues Several Documents of Importance to Health Centers
UPDATE: Check out the NACHC summary of the issues impacting FQHCs in the final rule and State Health Officials’ letter here. Last week CMS published two documents last week which will strengthen health centers’ and PCAs’ ability to protect their payment rights under Medicaid managed care. They are: A letter to State Health Officials …
ICHIA: The Legal Immigrant Children’s Health Improvement Act
By: Esther Grambs In 1996, the Personal Responsibility and Work Opportunity Act signed by President Bill Clinton barred legally residing immigrants from accessing Medicaid and CHIP benefits during their first five years of residency. The re-extension of these benefits was introduced by Senators Hillary Clinton and Olympia Snowe in 2007 as the Legal Immigrant Children’s Health …
CMS Announces Provider Call on Revalidation
We wanted to make sure you were aware of this provider call from CMS on Medicare revalidation. See the announcement below for information on the call and registration information. Provider Enrollment Revalidation Call — Register Now Tuesday, March 1 from 2 to 3:15 pm ET To Register: Visit MLN Connects Event Registration. Space may be …